本文關(guān)鍵詞：補腎止遺配方顆粒合敷臍療法治療小兒腎氣不足型遺尿癥的臨床研究　出處：《北京中醫(yī)藥大學》2013年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 補腎止遺配方顆粒 敷臍療法 臨床研究 小兒遺尿癥 腎氣不足

【摘要】：研究背景：小兒遺尿癥(NE),俗稱“尿床”,是兒科臨床上的常見疾病,是指兒童到了能夠控制膀胱排尿的年齡而仍不能從夜間睡眠中醒來而發(fā)生的無意識排尿行為。其病程多較長,影響小兒的精神和生活,也給患兒家長帶來諸多不便和苦惱,因此小兒遺尿癥的有效防治意義重大。目前西醫(yī)治療小兒遺尿癥有一定不良反應(yīng),停藥后易反復(fù),尚無明顯有效且無不良反應(yīng)的治療方法,主要以行為干預(yù)為主,中醫(yī)藥在治療方面有一定的優(yōu)勢。本課題根據(jù)導(dǎo)師長期治療小兒遺尿的臨床經(jīng)驗,提出在治療時運用宣肺益氣補腎法,研制出補腎止遺配方顆粒,重點在補腎止遺的基礎(chǔ)上,加用宣肺益氣藥物,關(guān)注氣在治療小兒遺尿方面的作用,并配合止遺尿外敷藥物,采用中醫(yī)內(nèi)外治相結(jié)合的方法,在臨床上取得了良好的療效。 研究目的：觀察補腎止遺配方顆粒合敷臍療法治療小兒遺尿癥的臨床療效及臨床安全性。 研究方法：按照納入和排除標準,選取東直門醫(yī)院兒科2011年3月到2013年2月時間段,西醫(yī)診斷為小兒遺尿癥,中醫(yī)診斷為小兒遺尿癥腎氣不足型的門診患兒48例,采用意愿隨機方法,治療組25例,對照組23例。治療組口服補腎止遺配方顆粒,且配合敷臍療法。對照組口服縮泉顆粒制劑。2周為1療程,連續(xù)用2個療程。治療期間,若出現(xiàn)病情加重或外敷過敏的情況,予以停藥。治療過程中隨時搜集臨床相關(guān)資料,觀察并記錄療程中患兒的遺尿次數(shù)、睡眠深度,小便情況,患兒面色、舌苔脈象等情況,治療2個療程后,評價療程前后患兒療效。 研究結(jié)果： 1.兩組基本資料比較：兩組患兒在性別、年齡、隱裂及病情輕重等方面進行比較,沒有明顯差異,具有可比性(p0.05) 2.總療效比較：治療組總有效率為96%,對照組總有效率78.26%,兩組總療效相比具有顯著差異,有統(tǒng)計學意義(p0.05) 3.主癥遺尿次數(shù)及睡眠深度改善比較：兩組在治療后遺尿次數(shù)的改善方面比較無差異,沒有統(tǒng)計學意義(p0.05),但是治療組在睡眠深度的改善方面優(yōu)于對照組,有顯著差異,具有統(tǒng)計學意義(p0.05) 4.癥狀改善比較：在尿量清多、神疲乏力、形寒肢冷、面色淡白、異常脈象方面,兩組比較有明顯差異(p0.05),在異常舌象的改善方面,兩組無顯著性差異(p0.05)。 5.藥物安全性：在臨床觀察期間,常規(guī)使用劑量范圍內(nèi),未發(fā)現(xiàn)胸悶、心慌、病情加重等臨床癥狀,僅有少數(shù)患兒在外敷藥物時出現(xiàn)發(fā)紅、疼痛情況,不予特殊處理,減少外敷時間的情況下癥狀可緩解,未發(fā)現(xiàn)明顯不良反應(yīng)及事件。 結(jié)論： 1.補腎止遺配方顆粒合敷臍療法組對于治療小兒遺尿在總體療效、睡眠深度及其他次癥尿量清多、神疲乏力、形寒肢冷、面色淡白、異常脈象等癥狀體征方面有顯著差異,優(yōu)于縮泉丸組,具有良好的臨床療效,可有效改善癥狀。在主癥遺尿次數(shù)方面及次癥舌淡苔白方面,與對照組相對比無顯著差異。 2.治療組補腎止遺配方顆粒合敷臍療法對治療小兒遺尿疾病療效及證候療效肯定,不僅可以改善患兒遺尿的相關(guān)主癥,而且可以改善諸多次癥,能夠提高患兒體質(zhì)。 3.僅有少數(shù)患兒在外敷藥物時出現(xiàn)發(fā)紅、疼痛情況,未發(fā)現(xiàn)明顯不良反應(yīng)及事件,安全性和耐受性較好。
[Abstract]:Background: nocturnal enuresis (NE), commonly known as "wet", is a common disease in pediatrics, unconscious behavior refers to the children to urinate can control bladder age still can not wake up from sleep at night and happen. Its course is long, affects children's spirit and life, but also to the children parents bring a lot of inconvenience and trouble, so the significance of effective prevention and treatment of infantile enuresis. At present the major medical treatment of children with enuresis has some adverse reactions, after discontinuation of easy relapse, there is no obvious effective treatment and no adverse reactions, mainly in behavior intervention, traditional Chinese medicine has certain advantages in the treatment. According to clinical experience the tutor of long-term treatment of enuresis in children, put forward to use the method in the treatment of kidney qi Xuanfei, developed kidney Zhiyi granules, based on the key in the kidney Zhiyi, with lung qi medicine Things, pay attention to the role in the treatment of infantile enuresis in terms of gas, and with arresting enursis topical drugs by using the method of combining traditional Chinese medicine and external treatment, achieved good curative effect in clinic.
Objective: To observe the clinical effect of Bushen granule combined check left umbilical therapy treatment of infantile enuresis and clinical safety.
Methods: according to the inclusion and exclusion criteria, select the Dongzhimen pediatric hospital from March 2011 to February 2013 period, western medicine for the diagnosis of infantile enuresis, traditional Chinese medicine diagnosis of infantile enuresis of kidney qi deficiency in children with 48 cases, using random method, 25 cases in the treatment group, 23 cases in the control group. The treatment group oral Bushen bushenzhiyi granules, and with the umbilical therapy. Control group was treated with Suoquan granules and.2 weeks for 1 courses, with 2 consecutive treatment. During the treatment, if illness or topical allergy, to stop drug treatment process. The related clinical data collected at any time, observe and record the treatment of children with enuresis times, sleep, urine the situation of children, complexion, tongue and pulse, after 2 courses of treatment, evaluation of curative effect before and after the treatment.
The results of the study:
1. comparison of the basic data of the two groups: the two groups of children were compared in terms of sex, age, cleavage, and the severity of the disease, and there was no significant difference (P0.05).
2. comparison of total curative effect: the total effective rate in the treatment group was 96%, the total effective rate of the control group was 78.26%. The total curative effect of the two groups was significantly different, with statistical significance (P0.05).
The 3. main symptoms of enuresis times and sleep improvement depth had no significant difference between the two groups after treatment the number of enuresis improvement was not statistically significant (P0.05), but the treatment group in the depth of sleep improvement than the control group, there were significant differences, with statistical significance (P0.05)
4., the improvement of symptoms was compared: there was a significant difference between the two groups (P0.05). There was no significant difference in the abnormal tongue improvement between the two groups (P0.05).
5. drug safety: in the clinical observation period, routine dose range, not found in chest, palpitation, illness and other clinical symptoms, only a small number of children in the external medicine when redness, pain, not special treatment, reduce the external time situation can alleviate the symptoms, no obvious adverse reactions and events.
Conclusion:
1. kidney Zhiyi granules and umbilicus therapy group for the treatment of infantile enuresis in general curative effect, the depth of sleep and other symptoms of urine clear, lassitude, cold limbs, pale white complexion, there is a significant difference of abnormal pulse and other symptoms and signs, is better than that of suoquanwan group, has good clinical curative effect that can effectively improve the symptoms. The main symptoms and secondary symptoms times of enuresis in pale tongue with white fur, compared with that in control group had no significant difference.
2. treatment group kidney Zhiyi granules with certain umbilicus therapy curative effects in the treatment of infantile enuresis disease and syndromes related symptoms can not only improve the children with enuresis, but also can improve the lot of disease, can improve children's physique.
3. only a few children were red, pain, no obvious adverse reactions and events were found in external application, and the safety and tolerance were better.

【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R272.6

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